§ 405.410 Selecting claims for Decision Review Board
review.
(a)(1) The Board may review
your claim if the administrative law judge made a decision under §§ 405.340 or 405.370
of this part, regardless of whether the administrative law judge's decision was
unfavorable, partially favorable, or wholly favorable to you.
(2) Claims the Board will
review may include those where there is an increased likelihood of error or
that involve the application of new policies, rules, or procedures. The Board will
review both allowances and denials of benefits. It will not review claims based
on the identity of the administrative law judge who decided the claim.
(b)(1) The Board may reopen
claims under subpart G of this part without regard to the time limits therein,
if, in the view of our effectuating component, the administrative law judge's
decision cannot be effectuated because it contains a clerical error affecting
the outcome of the claim, the decision is clearly inconsistent with the Act or
our regulations, or the decision is unclear regarding a matter that affects the
outcome of the claim.
(2) If the Board reopens
your claim, it will do so no later than 60 days from the date of the
administrative law judge's decision.
Background:
NPR: 70 FR 43590, 43598
We intend to screen every administrative
law judge decision, using computer-based predictive screening tools and
individual case record examination performed by skilled reviewers, to identify
cases for Decision Review Board review. The Decision Review Board will select
cases for review based, in part, on its identification of problematic policies
or on its own experience with processing cases that have been identified as errorprone by our Office of the General Counsel or by the
Federal courts.
The Decision Review Board
will monitor administrative law judge and district court decisions in order to identify
trends or developments relating to the quality and accuracy of administrative
law judge decisions throughout the country. We will conduct an ongoing review
of administrative law judge decisions that are either the subject of requests
for voluntary remand or are remanded to us by the Federal district courts. The results
of our review will help us to develop a profile of decisions that have a high
likelihood of resulting in errors.
The Decision Review Board
will focus its review on these decisions. Cases will not be selected for review
by the Decision Review Board based on the identity of the administrative law
judge who issued the decision or on the particular outcome of the decision.
Proposed rule:
§ 405.410 Selecting claims for Board review.
(a) The Board may review
your claim if the administrative law judge made a decision under §§ 405.340 or
405.370, regardless of whether the administrative law judge's decision was
unfavorable, partially favorable, or wholly favorable to you.
(b)(1) The Board may use
random sampling, the use of specific claim characteristics, a combination of
these two methods, or other methods to select claims for review. For example,
it may review claims that involve problematic issues or fact patterns that
increase the likelihood of error or claims that involve the application of new
policies, rules, or procedures. The Board will review both allowances and
denials of benefits and will not review claims based on the identity of the
administrative law judge who decided the claim.
(2) If your claim is
selected for review under paragraph (b)(1) of this
section, the Board will notify you of that selection and include with the
notice, the administrative law judge's decision.
(c)(1) We also will refer
your claim to the Board, for action under subpart G of this part without regard
to the time limits therein, if, in the view of our effectuating component, the administrative
law judge's decision cannot be effectuated because it contains a clerical error
affecting the outcome of the claim, the decision is clearly inconsistent with
the Act or our regulations, or the decision is unclear regarding a matter that
affects the outcome of the claim.
(2) Claims selected under
paragraph (c)(1) of this section will be referred to the
Board no later than 60 days from the date of the administrative law judge's decision.